J.A. Jansen

Implant Surface Roughness and Bone Healing: a Systematic Review

A systematic review was performed on studies investigating the effects of implant surface roughness on bone response and implant fixation. We searched the literature using MEDLINE from 1953 to 2003. Inclusion criteria were: (1) abstracts of animal studies investigating implant surface roughness and bone healing; (2) observations of three-month bone healing, surface topography measurements, and biomechanical tests; (3) provision of data on surface roughness, bone-to-implant contact, and biomechanical test values. The literature search revealed 5966 abstracts. There were 470, 23, and 14 articles included in the first, second, and third selection steps, respectively. Almost all papers showed an enhanced bone-to-implant contact with increasing surface roughness. Six comparisons were significantly positive for the relationship of bone-to-implant contact and surface roughness. Also, a significant relation was found between push-out strength and surface roughness. Unfortunately, the eventually selected studies were too heterogeneous for inference of data. Nevertheless, the statistical analysis on the available data provided supportive evidence for a positive relationship between bone-to-implant contact and surface roughness.

Maternal Prenatal Anxiety and Stress Predict Infant Illnesses and Health Complaints

OBJECTIVES: Evidence from both animals and humans suggests that maternal prenatal anxiety and stress can have adverse consequences on the offsprings development. Animal models also show that prenatal stress has programming effects on the physical health of the offspring, such as immune functioning. In human studies, however, physical health outcomes are often restricted to birth complications; studies on the effects of acquiring illnesses are scarce. This study aimed to examine whether maternal prenatal anxiety and stress, measured both by self-report and by cortisol physiology, are related to more infant illnesses and antibiotic use during the first year of life. METHODS: Participants in the study were 174 mothers with normal pregnancies and term deliveries (71 firstborns; 91 boys). The mothers filled out third-trimester questionnaires on general and pregnancy-specific anxiety and stress and provided saliva samples for circadian cortisol. Information on infant illnesses and antibiotic use was obtained through monthly maternal interviews across the infants first year of life. RESULTS: Hierarchical multiple regressions showed that, even after controlling for many relevant confounders, prenatal anxiety and stress predicted a considerable amount of variance in infant illnesses and antibiotic use: 9.3% for respiratory, 10.7% for general, 8.9% for skin, and 7.6% for antibiotic use. Digestive illnesses were not related to prenatal anxiety and stress. CONCLUSIONS: Although replication is warranted, to our knowledge, this is the first evidence linking maternal prenatal anxiety and stress to infant illnesses and antibiotic use early in life.

Cortisol reactivity in young infants

In this systematic review on empirical studies of cortisol reactivity to acute stressors in infants, we specifically focus on the role of infant age in the early development of cortisol reactivity to stressors. Our findings indicate that many psychological stressors do not provoke a cortisol reaction, but in response to physical stressors, the infant HPA-axis mostly reacts with a moderate increase in post-stressor cortisol. Furthermore, for physical stressors only, cortisol reactivity effect sizes decrease with infant age, although relatively little is known for infants older than 6 months. These data provide more insight in the role of infant age in the development of cortisol reactivity in response to acute stressors. We discuss the role of caregivers in buffering the cortisol response to both psychological and physical stressors, and recommend extending the current knowledge on infant cortisol reactivity.

Maternal prenatal stress and cortisol reactivity to stressors in human infants

Early life factors can shape the development of hypothalamic pituitary adrenal (HPA) axis. Maternal prenatal stress might constitute such an early environmental factor. As little is known about the relation between maternal prenatal stress and cortisol reactivity in human offspring, we performed a longitudinal study including four assessments of infant cortisol reactivity to stressful events in a non-clinical population. General and pregnancy-related feelings of stress and anxiety, as well as circadian cortisol levels, were measured in 173 mothers in the last trimester of pregnancy. Infant cortisol reactivity was measured at 5 weeks to a bathing session, at 8 weeks to a vaccination, at 5 months to a stressful mother–infant interaction (still face procedure), and at 12 months to a maternal separation (strange situation procedure). Maternal prenatal fear of bearing a handicapped child was a consistent predictor of infant cortisol reactivity. Although the effects were mild, higher fear was significantly related to higher salivary cortisol reactivity to the bathing session and to decreased cortisol reactivity to vaccination and maternal separation. Thus, pregnancy-specific anxieties predict infant cortisol reactivity in the first year of life, but the direction of the effect depends on infant age and/or the nature of the stressor. While this specific anxiety was a better predictor than stress experience or maternal cortisol concentrations, the underlying mechanisms of these associations remain unclear. Future studies should try to incorporate multiple measures of HPA-axis reactivity during development when studying the long-term consequences of maternal prenatal stress.

Soft-tissue response to injectable calcium phosphate cements.

In this study, the soft tissue reaction to two newly developed injectable calcium phosphate bone cements (cement D and W) was evaluated after implantation in the back of goats. For one of the cements (cement D) the tissue reaction was also investigated after varying the concentration of accelerator Na(2)HPO(4) in the cement liquid (resulting in cement D1 and D2). Eight healthy mature female Saanen goats were used. The cement was applied 10min after mixing while it was still moldable and plastic. The material was given a standardized cylindrical shape. Thirty-two implants of each cement formulation were inserted and left in place for 1, 2, 4, and 8weeks. At the end of the study, eight specimens of each material and healing period were available for further analysis. Two specimens were used for X-ray diffraction (XRD) and Fourier Transform Infrared Spectroscopy (FTIR) and six specimens were used for light microscopical evaluation. XRD and FTIR showed that the cements did set as microcrystalline carbonate apatite with the disappearance of monetite from the cements during implantation. Histological analysis showed that after 8weeks of implantation around all materials a thin soft-tissue capsule was formed (thickness ranging from 5 to 15 cell layers) with almost complete absence of inflammatory cells. Only in some specimens a slightly higher inflammatory reaction was observed. This was due to cement surface defects and a zone of dispersed particles near the cement-soft tissue interface. There was almost no resorption of the material after 8 weeks of implantation. In a few 4 and 8weeks samples, small areas of calcification were found in the fibrous capsule surrounding the implants. On the basis of our observations, we conclude that the tested cements were biocompatible and can be used next to soft tissue.

Osteoblast differentiation of bone marrow stromal cells cultured on silica gel and sol-gel-derived titania.

Primary cultures of osteogenic precursor cells derived from rat bone marrow stroma were performed on commercially available pure titanium discs (Ti c.p.) and surface modified Ti c.p.using a sol-gel technique (Ti sol). In separate repeated experimental runs, cell behavior and in vitro mineralization were compared with cultures on silica gel bioactive glass discs (S53P4). All substrates were incubated in simulated body fluid prior to the experiment. Overall, variable effects between experimental runs were seen. Apparently, this was due to the heterogeneous nature of the used cell population. Therefore, only careful conclusions can be made. Initial cell adhesion and growth rates between 3 and 5 days of culture--analyzed by cell numbers--were in general comparable for the two titanium substrates, while initial growth up to day 3 is suggested to be higher in Ti c.p. compared to Ti sol. Although initial cell adhesion on the S53P4 glass discs was lower than the titanium substrates, cell growth rates appeared to be higher on the silica gel compared to the two titanium substrates. Further, there were some indications that the early and late osteoblast differentiation markers, alkaline phosphatase and osteocalcin, monitored up to day 24, were elevated in Ti c.p cultures compared to Ti sol cultures. There were no differences observed in in vitro mineralization between the titanium groups. S53P4 seemed to display a substantially higher differentiating capacity for both osteogenic cell markers as well as in vitro mineralization compared to the two titanium substrates.

Cortisol in the first year of life: Normative values and intra-individual variability

INTRODUCTION Many studies have incorporated cortisol measurements when studying infant development, but descriptions of normal development of basal cortisol levels in large study populations are scarce. The present study aimed to establish norm values for infant basal cortisol levels and to examine the development of intra-individual variability in the first year of life. METHODS More than 2500 cortisol samples were collected in 300 infants at three different ages. At each age four 1100h samples were collected to determine average cortisol levels and intra-individual variability. The development of basal cortisol levels and intra-individual variability was analyzed with multilevel growth curve modeling. RESULTS Norm tables with 90 and 95% intervals are presented. Basal cortisol levels decreased gradually over the year. Intra-individual variability was relatively large and stable in the first half year but decreased towards the end of the year. CONCLUSIONS The results of this study will aid researchers in evaluating cortisol data collected in early infancy. It also underscores the importance of taking intra-individual cortisol variability into account in studies involving infants.

Non-viral bone morphogenetic protein 2 transfection of rat dental pulp stem cells using calcium phosphate nanoparticles as carriers.

Calcium phosphate nanoparticles have shown potential as non-viral vectors for gene delivery. The aim of this study was to induce bone morphogenetic protein (Bmp)2 transfection in rat dental pulp stem cells using calcium phosphate nanoparticles as a gene vector and then to evaluate the efficiency and bioactivity of the transfection. We also intended to investigate the behavior of transfected cells when seeded on 3-dimensional titanium fiber mesh scaffolds. Nanoparticles of calcium phosphate encapsulating plasmid deoxyribonucleic acid (DNA) (plasmid enhanced green fluorescent protein-BMP2) were prepared. Then, STRO-1-selected rat dental pulp stem cells were transfected using these nanoparticles. Transfection and bioactivity of the secreted BMP2 were examined. Thereafter, the transfected cells were cultured on a fibrous titanium mesh. The cultures were investigated using scanning electron microscipy and evaluated for cell proliferation, alkaline phosphatase activity and calcium content. Finally, real-time polymerase chain reaction was performed for odontogenesis-related gene expression. The results showed that the size of the DNA-loaded particles was approximately 100 nm in diameter. Nanoparticles could protect the DNA encapsulated inside from external DNase and release the loaded DNA in a low-acid environment (pH 3.0). In vitro, nanoparticle transfection was shown to be effective and to accelerate or promote the odontogenic differentiation of rat dental pulp stem cells when cultured in the 3-dimensional scaffolds. Based on our results, plasmid DNA-loaded calcium phosphate nanoparticles appear to be an effective non-viral vector for gene delivery and functioned well for odontogenic differentiation through Bmp2 transfection.

A new device for collecting saliva for cortisol determination

Saliva for measurement of cortisol is generally sampled by swabbing the mouth with a cotton roll, but this method has drawbacks. In the present study, we evaluated the use of an eye sponge as an oral collection device for saliva cortisol. The eye sponge was compared with commercial cotton rolls, and tested for use in infants as well as adults. Our results show that the eye sponge has adequate cortisol recoveries, even after samples have been kept at 4-8 degrees C for up to a week. In adults, volumes of 200-250 microl are obtained without problem; although smaller volumes are obtained in young infants, they are sufficient for assays requiring only 50-100 microl of saliva. In conclusion, the eye sponge is a valid and adequate collection device for saliva cortisol. Additional advantages as compared to cotton rolls are: more comfortable sampling, tastelessness, no need to manipulate the absorbing material, and the ease with which the untrained eye can determine that enough saliva has been collected.

Influence of precursor solution parameters on chemical properties of calcium phosphate coatings prepared using Electrostatic Spray Deposition (ESD).

A novel coating technique, referred to as Electrostatic Spray Deposition (ESD), was used to deposit calcium phosphate (CaP) coatings with a variety of chemical properties. The relationship between the composition of the precursor solutions and the crystal and molecular structure of the deposited coatings was investigated by means of X-ray diffraction (XRD), Fourier-Transform Infrared Spectroscopy (FTIR) and Energy Dispersive Spectroscopy (EDS). It was shown that the relative Ca/P ratio in the precursor solution, the absolute precursor concentration, the acidity of the precursor solution and the type of Ca-precursor strongly influenced the chemical nature of the deposited CaP coatings. Various crystal phases and phase mixtures were obtained, such as carbonate apatite, beta-TCP, Mg-substituted whitlockite, monetite, beta/gamma-pyrophosphate, and calcite. It was shown that carbonate plays an essential role in the chemical mechanism of coating formation. Carbonate is formed due to a decomposition reaction of organic solvents. Depending on deposition conditions, carbonate anions (a) react with acidic phosphate groups, (b) are incorporated into apatitic calcium phosphate phases, and (c) react with excessive Ca(2+) cations in case of phosphate-deficient precursor solutions.